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Home My WebLink About14994 (29)DIA)HIN1) Ii.11t CITY OF DIAMOND BAR DEPARTMENT OF COMMUNITY 21660 E. Copley Drive Suite 190 (909) 96063195 Fax (909) 861-3117 � BUILDING PERMIT APPLICA 9,3 w JOBSITE Q P/C ADDRESS NUMBER L M ISSUE APN LOT TRACT 5 OWNER 7- /� ADD Fj�SSW::69-4--9-4 GROUP CITYQJ$ ZIP TEL I,�'��j'�.f��,��'' APPLICANT TEL. FRONT CONTRAC O RW ADD S �TEL_ 3 CI ZIP ARCH/ENG/ DESIGNER ADDRESS Lij �! RW CITY ZIP TEL. D OWNER -BUILDER DECLARATION PROPOSED USE I HEREBY AFFIRM UNDER PENALTY PERJURY THAT 1 EXEMPT FROM THE CONTRACTORS �I R ( S PROFESSIONS CODE:MIY COYOA COUINTY WWRTNEFRESAPEOREASOH(SEC. 7031.5 WINP/MM1aL1i RE0URESAPERMRT000N37RUCT.ALTER NPROYE. DEM0U5H2OR REPAIRANY STiIUG TRUCT.ALTE IMPROVE. CJ TORE, PRIOR TO ITS ISSUANCE, ALSO REQUIRES THE APPLICANT FOR SUCH PERMIT TO RLE A SIGNED LI rt - STATEMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS Ll - DESCRIPTION CENSE LAW (CHAPTER S (COMMENCING WITH SECTION 7000) OF DIVISION 3 OF THE BUSINESS AND PRO - CENSE K FESSgNS CODE) OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- TION. ANY VIOLATION OF SECTION 7031.5 BY ANY APPLICANT FDR A PERMIT SUBJECTS THE APPLICANT TO ACIVIL PENALTY OF MOT MORE THAN FIVE HUNDRED DOLLARS (5600).): O L AS OWNER OFTNE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, Garage/CarpoR WILL 00 THE WORK. AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (SEC, 7044. BUSI- NESS AND PROFESSIONS CODE: THE CONTRACTORS LICENSE LAW DOES NOT APPLY TO AN OWNER OF 2 PROPERJYWHOSUJDS OR IMPROVES THEREON, AND WHODOES SUCH WOR( HIMSELF ORMERSELF OR THROUGH HIS OR HER OWH EMPLOYEES, PROVIDEDTHATSUGN IMPROVEMENTS ARE NOT INTENDED OR OFFERED FORSALE F, HOWEVEATHE BULOING OR IMPROVEMCNT rWWwrrHN ONE YEAR OFCOMPLE- TION, THE OWNER -BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR 1 . IMPROVE FOR THE PURPOSE OF SALE)..1. yJ❑ L AS OMER OF THE PROPERTY. AM EXCLUSMELY CONTRACTING WITH LICENSED CONTRACTORS L 7J TO CONSTRUCT THE PROJECT (SEC. 704, BUSINESS AND PROFESSIONS CODE: THE CONTRACTORS U - CENSE LAW DOES NOT APPLY TO AN OWNER OF A PROPERTY WHO BURD30R IMPROVES THEREON. AND C WHOOONTRACTS FOR SUCH PROJECTS WTHA CONTRACTOR(S)LICENSED PURSUANT TOTHE CONTRAC- TORS LICENSE LAW.). -Root O IAM EXEMPT UNDER SEC. B. S P.C. FOR THIS REASON DATE OWNER 4 Commercial _ LICENSED CONTRACTORS DECLARATION I HEREBY AFFIRM UMXR PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER • (COMMENCING WITH SECTION 7000) OF OMSKN S OF THE BUSINESS AND PROFESSKNS CODE, AND !� MY LICENSE IS N FULL FORCE AND EFFECT 7 1 LICENSE C L.C. INC. � a - NATE CONTRACTOR WORKERS' COMPENSATION DECLARATION n I HEREBYAFFIRM UNDER PENALTY OF PERJURY ONE OFTHE FOLLOWING DECLARATIONS: _IMAVEAND WILL MAINTAIN A CERTIFICATE OFOONSENTTO SELF -INSURE FORWORKERS' COMPENSATION, AS PROVIDED BY SECTION 37000E THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. ".1 I HAVEAND WILL MAINTAIN WORKERS'COMPENSATION INSURANCE, AS REQUIRED BY SECTION ADJ.AREA 3700 OF THE LABOR CODE, FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. MY KERS' COnMPENSATJN INSURANCE CARTER AND POLICY NUMBER ARE: DESCRIPTION CARRIER��,1" FEE POLICY NUMBER n 1 1 MiSSEC(ION NEED NOT BE OG PLENEDCFTNE PERMITG FOR ONE HUNDREDDOLLARSNIMOR LESS) I CERTIFY THAT LATHE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT 15 ISSUED. N (� SHALLNOT EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBJECT TO THE (q WORKERS'COMPENSATION LAWS OF CALIFORNIA, AND AGREE THAT F I SHOULD BECOME S SUBJECT TO THE WORKERS OOMPEN5ATON PROVISIONS OF SECTION 3700 OF THE LABOR D .I SHALL TH COMPLY WITH 7HQSE PROVISIONS. O A DATE. APPLOANT: _ - U WARM :FAILU TO BE...ERWCOMPENSATIN COVERAGE IS UNLAWFUL AND SHALL BE SJLJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND J DOLLARS (5100,000), N N ADDITI TO THE COST OF COMPENSATION, DAMAGE+AS PROVIDED FOR N THE INTEREST, AND ATT'ORNEY'S FEES. BECTON 3705 OF LABOR OWE, CONSTRUCTION LENDING AGENCY 1' I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT THERE IS A CONSTRUCTION LENDING AGENCY uz• FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED (SEC. 3007, CIV. C.). W LENDERS NAME LENDRI SADDAESS I CERTIFY THAT I HAVE READ THIS APP -1014 AND STATEE INFORM - THE ABOVE IS CORRECT. 1 AGREE TO COMPLY WITH ALL CITY AND COUNTY ORDINANCESANO STATE LAWS RELAYING TO BULDING CONSTRUCTION, AND HEREBY AUTHORIZE REPRFSENTATIV SOF THIS COUNTY TO ENTER UPON THE ABOVE-MENTKNED PROPERTY FOR INSPECTION PURPOS 9 QRAITTEE NAME (PENT) o. Co SIGNATURE OF PERL TTEE DATE & DEVELOPMENT SERVICES CION PRESS FIRMLY APPLICATION 9,3 w PERMIT Q P/C DATE NUMBER L M ISSUE TYPE OCC DATE CONST. GROUP ZONING SETBACKS FRONT RW ❑ REAR ❑ SIDE/SIDE STREET �! RW ❑ SIDE ❑ PROPOSED USE NO. DWEL. NO. NO. UNITS STORIES BEDROOMS DESCRIPTION SO. FT. FACTOR PSF ADJ. AREA/VALUATION SFR/ADD/REM ,n Garage/CarpoR W Patio/Deck LL POOUSpa ZRe -Root 4 Commercial co Valuation ADJ.AREA OUANTITY DESCRIPTION FEE U S U W z Z J o. a U Q x L11 CONSTRUCTION PLAN REVIEW ELECTRIC PLUMBING MECHANICAL INSPECTION FEE ISSUANCE SMTP nn(In ENERGY P/C ENERGY PERMIT �lrY Y - C S PW RETENTION FEE: PRE -ALT FEE:t.J TOTAL FEES — 5 COMMENTS i RECPT. NO. PAID BY VALIDATION WHITE—DeparlIm nt Copy, YELL—Flnance Copy, PINK—Assessor Copy, GOLDENROD --File Copy, GREEN—Applicant's Copy CITY OF DIAMOND BAR INSPECTION RECORD ` me SET BACK FLOOR JOIST' , FTGS/FORMS/STEEL �^ FHA REQMTS ELECTRIC. GROUND_ - UNDER FLOOR DUCT GROUND PLUMBING I UNDER FLOOR CONDUIT, SLAB GRADE FIREPLACE fOUNDATION- TEMP POWER FIREPLACE BOND13EAM WATER SERVICE MID HT BOND BEAM ROOF SHEATHING S FT. BOND BEAM FRAMIN_G/VENTILIATION FINAL BOND BEAM ROOF COVER PRE -GRADING ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING . . SHOWER/TUB TEST ( POOL ELECTRIC EXT. LATH/SIDING ) POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION OFF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER j FINAL ENG. SEPTIC TANK LANDSCAPElIRR1G, SEEP PIT/L.L. ON SITE IMPS. GAS AIR TEST FINAL ZONING - FINAL CONST.FIRE DEPT. FINAL FINAL HEATING TTHEALTWDEPT. FINAL FINAL ELECTRIC j DEV. FEES PAID FINAL PLUMBING ENERGY COMMENTS_ .... , :. SEPTIC TANK SIZE SEEP PITlU SIZE